Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.
Project ID: 213267 DEA: 04013584 EFIS: 0416000289
QA Service Level: 1
DIST-CO-RTE-PM: 04-SF-80-8.0/8.3,0.9/1.4
Work Description: Pier Retention
Location Description: In San Francisco and Alameda Counties on Yerba Buena Island and .4 miles west of Oakland Toll plaza
Contractor Name: Kiewit/Manson, AJV
Contractor Address: 4650 Business Center Drive, Fairfield,CA 94804
Resident Engineer: Brian Boal Structure Rep.: Unknown
DIME Sample ID: 2018-07-13-5
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - QASI Los Angeles Field Office
Sample Organization Contact: (858) 285-5797
Type of Sample: Acceptance
Type of Material: SMTL TM7 - Epoxy Coated Rebar
Sample Taken Date: 07/13/2018
Date that the sample was received by the laboratory/organization performing the testing: 07/18/2018
The quantity of what the sample constitutes: 23122 lbs
A brief description of the sample: Prefabricated rebar No 8
From where was the sample collected: Manufacturer
Laboratory sample identification:
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: CMC Rebar
Rebar Heat Number(s): 4073633
Rebar Epoxy Batch Number(s): 8D09 and 8D10
Rebar Coating Specification: ASTM A934
Rebar Size (#): 8
Rebar Coating Color: Purple
Rebar Manufacturer: CMC Steel
Rebar Coater: Fletcher Coating Company
Rebar Powder Manufacturer: Unknown
Release Number:
Quality Assurance Code:
DIME Test ID: 2018-07-13-5-1
Test Method: ASTM A934-13: Standard Specification for Epoxy-Coated Prefabricated Steel Reinforcing Bars (Epoxy-Coating)
Verified Date: 07/19/2018
Date Tested: 07/19/2018
Submitted By Organization: CT HQ - Sacramento Structural Materials Testing Laboratory
Organization Address: 5900 Folsom Boulevard,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: joshua.moore@dot.ca.gov
Organization Phone: (530) 329-6527
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified:
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Lower spec. limit LSL
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7 mils
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Upper spec. limit USL
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12 mils
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Bar # for First Bar
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8A
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Bar # for Second Bar
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8B
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First Bar Mean
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8.95
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Second Bar Mean
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9.16
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Total mean value
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9.05
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